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NCG020354_MONITORING INFO_20190212
STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. IV C& �� 0 DOC TYPE ❑HISTORICAL FILE MONITORING REPORTS DOC DATE , J ofI U� YYYYMMDD ANNUAL SUMMARY DISCHARGE MONITORING REPORT (DMR) — STORMWATER SUBMIT TO CENTRAL OFFICE* General Permit No. NCG020000 Calendar Year 2019 *Report ALL STORMWATER monitoring data on this form (include "No Flow"Mo Discharge" and Benchmark Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year. Certificate of Coverage No. NCG02 ®EOM Facility Name: Brickhaven No. 2 Mine Tract "A" County: Chatham Phone Number: ( Total no. of SDOs monitored 6 Certified Laboratory Research and Analytical Labs Late # 34 Lab # Stormwater Discharge Outfall (SDO) No. 1 VMA Outfall? Yes ❑ No x❑ Is this outfall currently in Tier 2 for any parameter? Yes ❑ No 0 Was this outfall ever in Tier 2 during the past year? Yes ❑ No E) If this outfall was in Tier 2 last year, was monthly monitoring discontinued? RECE 9F O Yes, enough consecutive samples below benchmarks to decrease frequency ❑ FEB 12 Z019 Yes, received approval from DEMLR to reduce monitoring frequency ❑ No, turbidity benchmark exceedances did not require monthly monitoring ❑ CENTRAL FILE` Other DVVR SECTION Outfall No. Total Rainfall, inches TSS, mgll SS, mill Turbidity, NTU Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU Non -polar O&G, mg1l (VMA) New Motor Oil Usage allmo. Stormwater Benchmarks indicate NO applicable Circle Benchmark 42160,0•1 Circle eeBenchGmarknn JV 511 V NIA Standard applies NIA Standard appllWaterQuality Water ea 1 >SSe" qui. average requlrea lar TO&0 monSS and itoring Date Sample Collected, molddl r 06/03/2019 0.91" 11.4 <0.1 12.3 NIA NIA NIA NIA 10/15/2019 0.27" 16.0 <0.1 20.5 1 NIA NIA NIA NIA Permit Date 1011/2015 — 9/30/2020 Last Revised 10-2-2015 Certificate of Coverage No. NCG02 ©00® Additional Outfall Attachment (make copies as needed for additional outfalls) Stormwater Discharge Outfall (SDO) No. 2 VMA Outfall? Yes ❑ No Is this outfall currently in Tier 2 for any parameter? Yes ❑ No Was this outfall ever in Tier 2 during the past year? Yes ❑ No If this outfall was in Tier 2 last year, was monthly monitoring discontinued? Yes, enough consecutive samples below benchmarks to decrease frequency ❑ Yes, received approval from DEMLR to reduce monitoring frequency ❑ No, turbidity benchmark exceedances did not require monthly monitoring ❑ Other ❑ 2 OutfNo. 2 Total Rainfall, inches TSS; mgll SS, mill Turbidity, NTU Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU Non -polar O&G, mgll (VMA) New Motor Oil Usage allmo. Stormwater Benchmarks fndicafe NO FLOWi( a FcaBle Circle Benchmark It d �0 0f� 1J.1 Circle Benchmark rr J� 511 NIA WaterCluallty Standard applies I NIA WaterGuallty Standard applies �'� �55galfmo. average requires TSS and Non -polar O&G msnitarin Date Sample Collected, molddl r NEEMMMMM 03/08/2019 0.97" 17.6 <0.1 15.0 NIA NIA NIA NIA 09/ 11 /2019 0.13" 35.5 <0.1 39.9 1 N/A N/A N/A NIA Permit Date 10/112015 — 9130/2020 Last Revised 10-2-2015 Certificate of Coverage No. NCG02 F1 3❑�® Additional Outfall Attachment (make copies as needed for additional outfalls) Stormwater Discharge Outfall (SDO) No. 3 VMA Outfall? Yet] No ❑ Is this outfall currently in Tier 2 for any parameter? Yes ❑ No ❑x Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑x If this outfall was in Tier 2 last year, was monthly monitoring discontinued? Yes, enough consecutive samples below benchmarks to decrease frequency Cl Yes, received approval from DEMLR to reduce monitoring frequency ❑ No, turbidity benchmark exceedances did not require monthly monitoring ❑ Other ❑ 3 Outfall No. 3 Total Rainfall, inches TSS, mgll SS, mIII Turbidity, NTU Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU Non -polar O&G, mgll (VMA) New Motor Oil Usage allmo. 5tormwater Benchmarks Indicate NO F`O1N'' a licable nchm Benchmark DU 0 0.1 Benchmark Benrcle chmark 50 5110 NIA WaterGuality Standard appllea NIA WaterQuality Standard appliea 15 allmo >SSgreclul average requires TSS and Non polar ORG monitorin Date Sample Collected, molddl r WEEMMMMM 02/05/2019 0.21" <5.0 <0.1 7.40 NIA NIA NIA NIA 09/23/2019 0.13" 11.4 <0.1 16.5 NIA NIA NIA NIA Permit Date 10/1/2015 — 9/30/2020 Last Revised 10-2-2015 Certificate of Coverage No. NCG02 0❑00® Additional Outfall Attachment (make copies as needed for additional outfalls) Stormwater Discharge Outfall (SDO) No. 4 VMA Outfall? Yes ❑ No g Is this outfall currently in Tier 2 for any parameter? Yes ❑ No Was this outfall ever in Tier 2 during the past year? Yes ❑ No x❑ If this outfall was in Tier 2 last year, was monthly monitoring discontinued? Yes, enough consecutive samples below benchmarks to decrease frequency ❑ Yes, received approval from DEMLR to reduce monitoring frequency ❑ No, turbidity benchmark exceedances did not require monthly monitoring ❑ Other 4 Outfall No. 4 Total Rainfall, inches TSS, mg/l SS, mill Turbidity, NTU I Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU Non -polar O&rG, mgll (VMA)(gal/Mo.) New Motor Oil Usage Benchmarks fndicaf¢ NO applicable CircleStormwater Benchmark Benchmark (MV50 ���w��� 0.1 Circle Benchmark �� ,5j110 N/A Standard appWaterGualilies s NIA Stalndard appater lies 15 aagereq55 i average requires TGdG and lar monitoring Date Sample Collected, molddl r 05/28/2019 0.26" 7.0 <0.1 6.48 NIA NIA NIA NIA 10/01/2019 0.13" 5.4 <0.1 5.43 NIA NIA NIA NIA Permit Date 10/1/2015 — 9/30/2020 Last Revised 10-2-2015 Certificate of Coverage No. N0002 ®3❑❑® Additional Outfall Attachment (make copies as needed for additional outfalls) Stormwater Discharge Outfall (SDO) No. S VMA Outfall? Yes ❑ No ❑ Is this outfall currently in Tier 2 for any parameter? Yes ❑ No ❑X Was this outfall ever in Tier 2 during the past year? Yes ❑ No If this outfall was in Tier 2 last year, was monthly monitoring discontinued? Yes, enough consecutive samples below benchmarks to decrease frequency ❑ Yes, received approval from DEMLR to reduce monitoring frequency ❑ No, turbidity benchmark exceedances did not require monthly monitoring ❑ Other ❑ Outfall No. 6 Total Rainfall, inches TSS, mgll SS, mill Turbidity, NTU Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU Non -polar O&G, mgll (VMA) New Motor Oil Usage allmo. Stormwater Benchmarks fndicafe NO FLOW it a ffca6fe Benchmark ark (ID 0 \� 0.1 Benchmark Circle ��+t �5J110 N/A Water Quality Standard applies NIA WaterQuality1 Standard applies s >65gal/ mo. average requires TSS mallon-polarorins 06G monkorin Date Sample Collected, molddl r WEEMMMMM 02/05/2019 0.21" 8.6 <0.1 8.89 NIA NIA NIA NIA 08/27/2019 0.91" 20.9 NIA NIA NIA NIA Permit Date 10/1/2015 - 9/3012020 Last Revised 10-2-2015 Certificate of Coverage No. NCG02 [flQM® Additional Outfall Attachment (make copies as needed for additional outfalls) Stormwater Discharge Outfall (SDO) No. 7 VMA Outfall? Yes ❑ No 0 Is this outfall currently in Tier 2 for any parameter? Yes ❑ No ❑x Was this outfall ever in Tier 2 during the past year? Yes ❑ No If this outfall was in Tier 2 last year, was monthly monitoring discontinued? Yes, enough consecutive samples below benchmarks to decrease frequency ❑ Yes, received approval from DEMLR to reduce monitoring frequency ❑ No, turbidity benchmark exceedances did not require monthly monitoring ❑ Other ❑ 7 Outfall No. Total Rainfall, inches TSS, mgll SS, mlll Turbidity, NTU Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU Non -polar O&G, mg/l (VMA) New Motor Oil Usage allmo. Stormwater Benchmarks lndicato NO aF1.OWil be Circle Benchmark /{ A�1Y�o 0.1 Circle Benchmark 1p sj/i 0 NIA Standard applies NIA Standard applies �55 gallmo. average requires TSS OLG mon tadand n ar Date Sample Collected, molddl r EN===== 05/28/2019 0.26" 16.4 <0.1 20.7 NIA NIA NIA NIA 08/27/2019 091" 22.2 <0.1 34.0 NIA NIA NIA NIA Permit Date 10/1/2015 — 9/30/2020 Last Revised 10-2-2015 Certificate of Coverage No. NCG02 l[j] 5❑® CERTIFICATION "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." [Required by 40 CFR §122.22] Signature Date February 11, 2020 o uyh sre�ea er rao�r�u� om��. nw c.us. l,, .,. o: C i ,h u.V, ou- Erpm+ E-W & q..AV. ["-�n Owe.. U.1s:7929.02. 11010I 75-059Q Mail Annual Summary Stormwater DMR to the NCDEQ Central Office: Note the address is correct — Central Files is housed in DWR (not DEMLR) N.C. Department of Environmental Quality (DEQ) Division of Water Resources Attn: DWR Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 Central Files Telephone (919) 807-6300 Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at: (919) 707-9220 Permit Date 1011/2015 — 9/30/2020 Last Revised 10-2-2015 ANNUAL SUMMARY DISCHARGE MONITORING REPORT (DMR) —WASTEWATER SUBMIT TO CENTRAL OFFICE* General Permit No. NCG020000 Calendar Year 2019 "Report ALL WASTEWATER monitoring data on this form (include "No Flow"Mo Discharge" and Limit Violations) from l the previous calendar year to the DEQ by MARCH 1 of each year. Certificate of Coverage No. NCG02 ©3❑ 5❑® RF- PIS -, Facility Name: Colon Mine 9 County: Lee Phone Number: Total no. of oytfal(s- gnttored 1 Certified Laboratory Research & Analytical Laboratories, Inc. Lab # 34 Lab # Wastewater (WW) Discharge Outfall No. MP-01 Is this an industrial sand mine (See 40 CFR §436 Subpart D)? Yes ❑ No Does this outfall discharge WW to SA waters? Yes ❑ No IN Does this outfall discharge WW to SB or PNA waters? Yes ❑ No Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No ❑X If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑ Does this outfall discharge WW to Trout jr) designated waters? Yes ❑ No ❑X Were there any limit violations in the calendar year? Yes ❑ No ❑X Outfall No. 1 Daily Flow Rate, cfs pH, SU. TSS, mgll SS, mlll ffapplicable Discharge Turbidity, NTU Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU Fecal Coliform, col/100 ml SA Effluent Limitations Mo. Ave) Daily Max, HQW ar ORW 50% of 7Q10 lndicare NO FLOW if applicable Ireshwater 6.0-9.0 saltwater 6.8-8.5 Industrial Sand 25145 HOworORW 20130 HQ. or 0RW iQA Tr or PNA 10115 HQW, pRW, SA, s9,PNA, orrany Trout 0.1 /0.2 No Limit Circle Water Quality that applieStansard 511 0 NIA Water Quality Standard applies NIA Water Quality Standard applies NIA Date Sample1�:: Collected, moldd! r <_`°; �{' } _ �, 2 rrj.; 02/19/2019 0.045 7.03 9.8 <0.1 19.2 NIA NIA NIA 06/25/2019 0.011 6.75 11.2 <0.1 20.5 N/A N/A NIA 08/29/2019 0.022 6.82 12.8 <0.1 8.79 NIA NIA NIA 12/ 19/2019 0.045 7.40 <5.0 <0.1 11.4 NIA NIA NIA Permit Date 10/1/2015 — 9/30/2020 Last Revised 10-2-2015 Certificate of Coverage No. NCG02 t)❑ 3❑ 5❑® CERTIFICATION " i certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." [Required by 40 CFR §122.22] r7 [ DNU; Hl' :+9nntl W Norman orvnia c=us, E•nm ers®amen. nm 0- r o••cliaran. uc•. L En.rpm�sny A Signature QU- W, CN-N QyW":20 0MA I an 4 41- aa�:�ozo.ez.,, o,.1.„_0D Date February 11, 2020 Mail Annual Summary Wastewater DMR to the NCDEQ Central Office: Note the address is correct - Central Files is housed in DWR (not DEMLR) N.C. Department of Environmental Quality (DEQ) Division of Water Resources Attn: DWR Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 Central Files Telephone (919) 807-6300 Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at: (919) 707-9220 Permit Date 1011/2015 — 9/30/2020 Last Revised 10-2-2015 RESEA Ch & ANA[ylricAI Report of Analysis r: LAORUORiES� ONC. 2/28/2019 sµ►rirrrrri� ANA For: Charah, LLC .�`G.�lrp"i,�'O 435 South Tryon Street Suite 180 Charlotte, NC 28202 •o z� (P :CO NC t434 Attn: Kyle Hoover y NC tt37701 = i y • r �.QSCT�¢' �� 44111111311110 Client Sample ID: MP-01 Lab Sample ID: 63253-01 Site: Colon Mine Collection Date: 2/19/2019 14:31 Parameter Method Result Units Rep Limit Analyst Analysis Date/Time pH SM 4500 1-1+13-2000 7.03 Std. Units 2/19/2019 1431 Settleable Matter SM 2540 F-1997 <0.1 tnlll 0.1 AW 2/20/2019 1430 Total Suspended Solids (TSS) SM 2540 D-1997 9.8 mg/L 5 AW 2/25/2019 Turbidity EPA 180.1 19.2 NTU 1 AW 2/21/2019 0940 NA = n01 ❑ric:Iy;', Ci P.p. Bax 473 106 Short Street Kernersville, North Carolina 27284 Tel: 336-996-2841 Fax: 336-996-0326 wvmrandalabs.cow Page 1 RESEARCh & ANALYTICAL UbORmoidcS, ANC. Analytical / Process Consultations Phone (336) 996-2841 CHAIN OF CUSTODY RECORE) I!'uler / Wave wafer MINC. r+1 at h So Job i\iu. ; v C a - o` _ v ° ° c O T �= +y cc _ c i f 2 = z w c' rt r_ e _ _ -til I 1 �,I,kr.•„ �j����� �y�( _ ��_� r 'il?', �IaH•, /JI) Sari-pvrdl NG a7330 i'jr'ujefi /� f�� � Ca Vi , rte, lYr(AQ. A0,4 - f ft Sa nlhifr ii0mf (Plensc Print) (bo b l56k w !'„uta,•t T hhnne Sam cr : iynnturc latr 1iuu (urnp. (ral Temp ��. ltcs. Cl. Clrluriae Removed Itr M1 Smple N11rii ti ur Sample nCa[ion I I.D. I r.M li {1,'flfllyl R,tell Annlr,isau �C a-19—i4 3c x P-ot ——I:e4+nglthhed �Uut,•fl'im lid- eH'ed Lh. Rerttark% P I. •Inulc u m ri-ime 3 Itcreitied 0) '� [In I<c sumple Tctuperature at reeeiltt "t nm_ " i�ii� �, If iI ! i,�' ii fix 'e i,1 i, �� 11� ,; ;, ,�, I ; For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 7/3/2019 1��11111I Ffo' 64. .Q D:Vnr NC 434 Z. NC 1137701 Client Sample ID: MP-01 Lab Sample ID: 68639-01 Site: Colon Mine Collection Date: 6/25/2019 13:24 Parameter Method Result Units Rea Limit Analyst Analysis DaterTime pH SM 4500 H+B-2000 6.75 Std. Units 6/25/2019 1324 Settleable Matter SM 2540 F-1997 <0.1 mlll 0.1 AW 6/26/2019 1400 Total Suspended Solids (TSS) SM 2540 D-1997 11.2 mg1L 5 AW 6/27/2019 Turbidity EPA 180.1 20.5 NTU 1 AW 6/26/2019 1600 NA = not analyzed P.O. Sox 473 106 Short Street Kernersville, North Carolina 27284 Tel: 336-996-2841 Fax: 336-996-0326 www.randalabs.com Page 1 -a+ cou b=�sic ,1ra RESEARCk & ANALyTiCAL UbORATORIES, INC. Analytical / Process Consultations Phone (336) P96-2941 CHAIN OF CUSTODY RECORD 1ircrfer/If'astefverfer• ,4fisr. -- - 4'nmp:Ils:' i tiu•.•••l ,3111Eresti ( Ill. )BIr. /.Ill �Spr�}or�, NC Z7E30 -- - .I01 tiff. - y1 Y x l.: ;,� •, r y � R ' tC- �% � C n ° _ `" a E C r Y T Y Y F r c ` J � — a C a („ - � d L— c <L J w r t. 4 r a.L ..! w G , J u Va ••• N i=ru ccl c10 Nirn f�aS ll +1 .larlipler Name (Please I rino r Gf, busof� {•�nllarl l:1(Y c7M+nbc45G� l�hatl CSaz)631-c+G-t3 S ar!lIICI'.�Ij�llalll C.- p ��n�,.i.••..mf,rr Da IL. T11ne comp. Grab 7'clnp tl (- Ilca. (.1. Chlorine IletnnYed 1' nr \ Sample it1ntrit ti nr �Y Sample LAwatioRI I.D. ''�• d % I I.71r f!hl'1)Ilfl! - ill' %scs4vd A r1111%'%i% -zs- w --P.-bmIlli"Ilt'd 1t}' lhalefl'illlc T.` ~ ivell ki I' r sicu kty ( jIQhvfcfr'in:. k{crcived U�' 1(cmarks 10On ice Sampir leutperslure al reccipl 3 3 W '( W RESEARCk& A14AIy1riCA[ Report of Analysis UbowwiIES' Ncs 9/6/2019 911111oo.. ��r For: Charah LLC 435 South Tryon Street Suite 180 ,•`�QG .•••••., Charlotte NC 28202 : ° o'• cn 10 NC #34 r Attn: Kyle Hoover V. NC437701 • Client Sample ID: MP-01 Lab Sample ID: 71446-01 Site: Colon Mine Collection Date: 8/29/2019 15:18 Parameter Method Result Units Rep Limit Analyst Analysis DaterTime pH SM 4500 H+8-2000 6.82 Std. Units 8/29/2019 1518 Settleable Matter SM 2540 F-1997 <0.1 ml/I 0.1 AW 8/30/2019 1600 Total Suspended Solids (TSS) SM 2540 D-1997 12.8 mg/L 5 AW 9/4/2019 Turbidity EPA 180.1 8.79 NTU 1 AW 8/30/2019 1600 NA = not analyzed P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: 336-996-2841 Fax: 336-996-0326 www.randalabs.com Page 1 gal _o+ 'r,3sf:' vi RESEARCh & ANA1yTICA1 LAbowoRks, 1NC. Analytical / Process Consultations Phone (336) 996-2841 CHAIN OF CUSTODY RECORD s� • r � �•A M31111 Sampler Mime (plt!-1Pp1h-0 U r,. ■ XESEARch & ANAlyricAl LAboRATORiES� INC. For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 12/31/2019 C q :co NC 434 Sn Z. NC 437701 °a U APB, Client Sample ID: MP01 Lab Sample ID: 76331-01 Site: Colon Mine Collection Date: 12/19/2019 10:49 Parameter Method Result Units Rep Limit And Analysis DatefTime pH SM 4500 H+B-2000 7.40 Std. Units 12/19/2019 1049 Settleable Matter SM 2540 F-1997 <0.1 ml/I 0.1 AW 12/2012019 0745 Total Suspended Solids (TSS) SM 2540 D-1997 <5 mg1L 5 AW 12/2312019 Turbidity EPA 180.1 11.4 NTU 1 AW 12/20/2019 1030 NA = not analyzed P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: 336.996-2841 Fax: 336-996-0326 www.randalabs.com Page 1 RESEARch & ANALyTiCAI LABORATORIES INC. Analytical / Process conoultatlons Phone (336) 996-2841 CHAIN OF CUSTODY RECORD ISM ANNUAL SUMMARY DISCHARGE MONITORING REPORT (DMR) —WASTEWATER SUBMIT TO CENTRAL OFFICE* General Permit No. NCG020000 Calendar Year 2019 *Report ALL WASTEWATER monitoring data on this form (include "No Flow"/"No Discharge" and Limit Violations) from the previous calendar year to the DEQ by MARCH 1 of��h•ye�re„ a„_._ Certificate of Coverage No. NCG02 UUUU FEB 12 2019 Facility Name: Brickhaven No. 2 Mine Tract "A" Chatham •EN j;Njt��_ s-ILE �, County: DtC R r; _ Tln�! Phone Number: (� Total no. of out a f's monitored 1 Certified Laboratory _ Research & Analytical Laboratories, Inc. Lab # 34 Lab # Wastewater (WW) Discharge Outfall No. MP-01 Is this an industrial sand mine (See 40 CFR §436 Subpart D)? Yes ❑ No S] Does this outfall discharge WW to SA waters? Yes ❑ No EN Does this outfall discharge WW to SB or PNA waters? Yes ❑ No Does this outfall discharge WW to HQW or ORW waters? Yes ❑ No ❑X If so, what is the 7Q10 flow rate? or Tidally influenced waters, 7Q10 not available ❑ Does this outfall discharge WW to Trout (Tr) designated waters? Yes ❑ No ❑X Were there any limit violations in the calendar year? Yes ❑X No ❑ Outfall No. MP-01 Daily Flow Rate, cfs pH, SU TSS, mg/1 SS, mIII irappficable Discharge Turbidity, NTU . Upstream (U) Turbidity, NTU Downstream (D) Turbidity, NTU Fecal Coliform, co11100 ml SA Effluent Limitations Mo. Ave I Daily Max. HQW or 0RW 50% of 7Q10 Indicate NO FLOW of applicable freshwater 6.0-9.0 saltwater 6.8-8.5 Industrial Sand 25/45 HQW or0RW 20I30 HQW or 0RW and Tr or PNA 101 15 HQW, ORW, SA, 50, PNA, or any Trout 0.110.2 No Limit Circle Water 0 uality that applies: esard 50/25/10 NIA Water Quality Standard applies NIA Water Quality Standard applies NIA Date Sample Collected, molddl r MEMEMMMM 03/28/2019 0.67 5.40 <5.0 <0.1 6.33 NIA NIA NIA 06/24/2019 0.67 6.24 <5,0 <0.1 1.33 NIA NIA NIA 08/27/2019 0.67 5.99 <5.0 <0.1 8.42 NIA NIA NIA 11/20/2019 0.56 6.57 <5.0 <0.1 3.67 NIA NIA NIA Permit Date 101112015 — 9/30/2020 Last Revised 10-2-2015 Certificate of Coverage No. N0002 ®3❑ $❑® CERTIFICATION "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." [Required by 40 CFR §122.22] Signature Date February 11, 2020 flCp,0„�, ghee er namsma.e�. I. LLC', au�'E.q�rtaalnY. En�i.�...—1 A a lkl f, an.Na�� O1':ia o1.i i oe 345io5'Otr Mail Annual Summary Wastewater DMR to the NCDEQ Central Office: Note the address is correct — Central Files is housed in DWR (not DEMLR) N.C. Department of Environmental Quality (DEQ) Division of Water Resources Attn: DWR Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 Central Files Telephone (919) 807-6300 Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at: (919) 707-9220 Permit Date 10/1/2015 — 9/30/2020 Last Revised 10-2-2015 3S LI b RESEARCh ANA1YTiCA For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 6/6/2019 } Iqurrlly��i Jk"- "P.- M NCn34 Z� : NC037701 40 Nk 5 . ,r��rr11111��* Client Sample ID: SBO #1 Lab Sample ID: 67498-01 Site: Brickhaven-Stormwater Discharge Collection Date: 6/3/2019 15:14 Parameter Method Result Units Rep Limit Analyst Analysis Date/Time Settleable Matter SM 2540 F-1997 <0.1 mIR 0.1 AW 6/5/2019 0900 Total Suspended Solids (TSS) SM 2540 D-1997 11.4 mg1L 5 LP 6/4/2019 Turbidity EPA 180.1 12.3 NTU 1 LP 6/4/2019 1415 NA = not analyzed P.D. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: 336-996-2841 Fax: 336-996-0326 www.randalabs.com Page 1 Ial C:)�1 t)r^, 511: YIr RESEARch & ANAiYTiCAt LA ORAT®RiES� INC. For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 10/18/2019 'Q �co NC A34 Z. s NC 037701 fo Client Sample ID: SBO #1 Lab Sample ID: 73584-01 Site: Brickhaven-Stormwater Discharge Collection Date: 10/15/2019 14:19 Parameter Method Result Units Rep Limit Analyst Analysis Date Settleable Matter SM 2540 F-1997 <0.1 mIA 0.1 AW 10/16/2019 1310 Total Suspended Solids (TSS) SM 2540 D-1997 Turbidity EPA 180.1 16.0 mg/L 5 AW 10/16/2019 20.5 NTU 1 AW 10/17/2019 1224 NA = not analyzed P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: 336-996-2841 Fax: 336-996-0326 www.randalabs.com Page 1 rsl coa baSiC 4Id U'(ESEARCh & ANA yTiCAI r, LA ORATORIES, INC. For: Charah, LLC 435 South Tryon Street suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 3/11/2019 �f"tll=lIlift r �,•`'�,b CYT�'*# to NC M 3 4 Z (((JJJ777 r NC437701 Client Sample ID: SBO #2 Lab Sample ID: 63930-01 Site: Bric&haven-Stormwater Discharge Collection Date: 3/8/2019 10:32 Parameter Method Result Units Rea Limit Analyst Analysis Date/Time Settleable Matter SM 2540 F-1997 <0.1 mill 0.1 AW 318/2019 1345 Total Suspended Solids (TSS) SM 2540 D-1997 17.6 mg/L 5 AW 318/2019 Turbidity EPA 180.1 15.0 NTU 1 AW 318/2019 1611 NA = not analyzed ...-------_. __----_ ..— __... - P.O. Box 473 106---- Sha—ri Streel_ Kernersviile,- _ -- Norih. __ Ca_rolina_--27284-_.--._Tel: 336-996-2841 Fax:---_ --- 336-936-0326 vr--ww.randalabs.co- ----- -m- - Page-- 1- RESEARck & ANAty1racA[ LAORAT®ReEs, If4c. For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 9/17/2019 Qr NC 1134 z - NC 437701 f�E� AN�`�+•`• Client Sample ID: S80 #2 Lab Sample ID: 71873-01 Site: Brickhaven-Stormwater Discharge Collection Date: 9/11/2019 10:30 Parameter Method Result Units Rea Limit Analyst Analysis Date/Time Settleable Matter SM 2540 F-1997 <0.1 mlll 0.1 AW 9/11/2019 1415 Total Suspended Solids (TSS) SM 2540 D-1997 35.5 mglL 5 AW 9/12/2019 Turbidity EPA 180.1 39.9 NTU 1 AW 9/12/2019 1240 NA = not onoWed P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: 336-996.2841 Fax: 335-996-0326 www.randalabs.com Page 1 31 S-oa 'w"!c V Lr' RESEARCh & ANA[y1rBCA1 LA ORAr®RiESy INC. For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 2/8/2019 ` ��ti�tetrty�4 • �4r �A. ern = NC 434 i' (n NC .37701 Client Sample ID: SBQ #3 Lab Sample ID: 62622-01 Site: Brickhaven-Stormwater Discharge Collection Hate: 2/5/2019 12:16 Parameter Method Result Units Rep Limit Analyst Analysis Date/Time Settleable Matter SM 2540 F-1997 <0.1 M14 0.1 AW 218/2019 1430 Total Suspended Solids (i'SS) SM 2540 D-1997 Turbidity EPA 180.1 <5 mglL 5 AW 202019 7.40 NTU 1 AW 2/0/2019 1551 NA = not analyzed P.p, Box 473 106 Short Slreet Kernersville, Nortf� Carolina 27284 TeL 336-996-2841 Fax: 336-995.0326 www.randalabs.com Page 1 r�� c� n5ir., t•t: � • ij i. I j i isI 1!{ y' w� ` 33 ?��d, .� For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 1 0J2/2019 so oD NC 434 Z; to = NC 07701 ASP,' Client Sample ID: SBO #3 Lab Sample ID: 72470-01 Site: Srickhaven-Stormwater Discharge Collection Date: 9/23/2019 14:11 Parameter Method Result Units Rep Limit Analyst Analysis DatelTime Settleable Matter SM 2540 F-1997 <0.1 mI11 0.1 AW 9/24/2019 1400 Total Suspended Solids (TSS) Turbidity SM 2540 D-1997 EPA 180.1 11.4 16.5 mg/L 5 AW 9/26/2019 NTU 1 AW 9/24/2019 1612 NA = not analyzed P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: 336-996-2841 Fax: 336-996-0326 www.randalabs.com Page 1 ral rnA tY15fr: v f fi 9 I I a'. i < i tau- i. Ii W LAORMORkSil, For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, INC 28202 Attn: Kyle Hoover Report of Analysis 6/4/2019 Client Sample ID: SBO #4 Lab Sample 1D: 67272-01 Site: Brickhaven -Stormwater Discharge Collection Date: 5/28/2019 16:00 Parameter Method Result Units Rep Limit Analyst Alysi nas DatelTime Settleable Matter SM 2540 F-1997 <0.1 mIll - 0.1 Y AW 5/29/2019 1430 Total Suspended Solids (1-SS) SM 2540 D-1997 7A mg/L 5 AW 5/30/2019 Turbidity EPA 180A 6.48 NTU 1 AW 5129/2019 1422 NA = not analyzed P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: 336-996-2841 Fax: 336-996-0326 www.randalabs.com Page 1 rai rare ha'at; v'r! �ESEARCh & ANAIYTiCAI LAORATORiES, NCO For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 10/9/2019 pt<tttttt?t���i NC #34 Z. S NC 437701 • i Client Sample ID: Si30 #4 Lab Sample ID: 72880-01 Site: Brickhaven-Storrnwater Discharge Collection Date: 10/1/2019 17:22 Parameter Method Result Units Rep Limit Analyst Analysis DatelTime Settleable Matter SM 2540 F-1997 <0.1 mIA 0.1 AW 10/212019 1500 Total Suspended Solids (TSS) SM 2540 D-1997 5.4 mg/L 5 AW 10/3/2019 Turbidity EPA 180.1 5.43 NTU 1 AW 10/212019 1625 NA = not analyzed P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel; 336-996-2841 Fax: 336.996-0326 www.randalabs.com Page 1 ral cua hasi. vlci UIESEARCh & ANA1y1FncA[ 36,,: LA®RAir®RiES, Ptico For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 2/8/2019 trrtttt�t��fl, �,�' NC U34 z: en NC #37701 r � eut ��xlrttt�r►►►►t Client Sample ID: SBO 46 Lab Sample ID: 62623-01 Site: Brickhaven-Stormwater Discharge Collection Date: 2/5/2019 12:39 l fParameter Method Result Units Rep Limit An_ alyst Analysis_Da_telTime I Settleable Matter SM 2540 F-1997 <0,1 ml/l 0.1 AW 2/6/2019 1430 `!!! Total Suspended Solids (TSS) SM 2540 D-1997 Turbidity EPA 180.1 8.6 mglL 5 AW 2/6/2019 8,89 NTU 1 AW 2/612019 1555 NA = not analyzed P.O. Box 473 106 Short Street Kernwsville, North Carolina 27284 Tel: 336-996-2841 Fax: 336-996-0326 www.randatabs.com Page 1 KESEARCh & ArWyirQcAl For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 8/29/2019 } ��itifrifr�ffaaa AMtYT0I *. 4 NC434 Zi = NCh37701 40 afffstill Client Sample ID: Brickhaven Stormwater S606 Lab Sample ID: 71282-01 Site: Charah, Inc Collection Date: 8/27/2019 9:52 Parameter Method Result Units Rep Limit An_ alyst Analysis Daterrime Settleable Matter SM 2540 F-1997 <0.1 ml/I 0.1 AW 8/27/2019 1430 Total Suspended Solids (TSS) SM 2540 D-1997 17.6 mg/L 5 AW 8/28/2019 Turbidity EPA 180.1 20.9 NTU 1 AW 8/28/2019 0935 NA = not analyzed P.O. Box 473 106 Short Street Kernersville. North Carolina 27284 Tel: 336-996-2841 Fax: 336-996.0326 www,randalabs.com Page 1 'rtl ron basif, .ld' RESEARCh & ANAIYTiCAI :. LA®raa.T®RiES, NCO For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 6/4/2019 cu a e p A 's co NC #34 z; cn NC $137701 w : i 5iti, Client Sample ID: SBO V Lab Sample ID: 67271-01 Site: Brickhaven-Stormwater Discharge Collection Date: 5/28/2019 10:21 Parameter Method Result Units Rep Limit Analyst Analysis Date/Time l Settleable Matter_ SM 2540 F-1997 W <0.1 ml/I_ 0.1 AW 5/29/2019 1430 Total Suspended Solids (TSS) SM 2540 D-1997 16A mg/L 5 AW 5/30/2019 Turbidity EPA 180.1 20.7 NTU 1 AW 5/29/2019 1415 NA = not onClyzed P.O. Box 473 1Db Short Street Kernersville, North Carolina 27284 Tel: 336-996-2841 Fax: 336-996-D326 www.randalabs.com� _ Page 1 SI c:na I�Ff,ir, J'id RESEARCk & ANA1YTiCA1 i . r LA ORAimiES, INC. i For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 8/29/2019 .o �di NCtt34 Z. S� NC #37701 Client Sample ID: Brickhaven Stormwater SB07 Lab Sample ID: 71283-01 Site: Charah, Inc Collection Date: 8/27/2019 9:24 Parameter Method Result Units Rep Limit Analyst Analysis DatelTime Settleable Matter SM 2540 F-1997 <0.1 ml/I 0.1 AW 8/27/2019 1530 Total Suspended Solids (TSS) SM 2540 D-1997 22.2 mg/L 5 AW 8/28/2019 Turbidity EPA 180.1 34.0 NTU 1 AW 8/28/2019 0940 NA = riot anclyzed P-O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: 336-996-2841 fax: 336-996-0326 www.randalabs.com Page 1 Part A Continued: Wastewater Monitoring RLquiretnents 4701 outfhlt No �,� � :-G�13�' � ' � .4 ,',°�l"i�;''"' ; '�° y���sS�,4� slt�nti� ' � ���-it%�h1�r=, `Cii�bltSlt�' Settleable Solids pH Decal Coliforms . tlt�iiftyi- vti-' 5. �.,�fisi1 y iL` m1112 Standard' col/ml:,a Po �_ 01 Jul, I t9___-— P1Pb- ( -- 0-1b Apo I Cs i.a s t y4-- r4P41 0 orfi9 rr t o I 3cx) 7 Welk-- — - --- MQOt 0i t)1 .. — --- --- 110 -0,01bg 3 — — - f�° 000 of d I 01 _— MAIL ORIGINAL AND ONE; COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCIIAW_.' V" & 1XV11T VIOLATIONS) BY 111ARC11 1 OF FAC1-1 YEAR TO: Division of Water Quality Attn: DWQ Central Piles 1617 Mail Service Center RECF1\1E Raleigh, North Carolina 27699-1617 (919) 807-6379 FEB 12 2019 V0I/ ilfUST SIGN TIIIS CERTIFICATION FOR ANY INF'ORA?ATION REPURTED: CEN 1 t:I,L FILES I certify, under penalty of law, that this document and all attachments were prepared under my'direeHw+r�r supervisiun in accordance +with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and beliel', true, accuritle, and complrle. I am aware flan, thrrP FwN donifmint tie tltaes for submitting false information, including the possibility of fines and imprisonment for knowing violations," 1 I Ff (Signs; ure of Nrmitteef (Date) Permit Date: 1/1/2010-12/31/2014 Lab[ Revised 02-01- 1 1 P'ICC 3 of-2 P Part A Continued: Wastewater Monitorine Requirements reI6r'-Aar'-N dotct Outthll t1 y` yhLir f''`'� s � �+- � rxI �t: ;.p 1,.,;, s �'it1t t le Solids Settleable firs pH - ;' r�;..,-.. �• . mill, Standard; tvlQOq2h l I vi O'1 Pa 1 o 7- 10— W01 02 I04414 — — — Tf_4Q6l -_ —� o2LOG It -- --Apok --Apo oL/nft-i M� I odloY 16y- w[Pa— Apo t a loll -- -- — -- - _ APO — �i l r1 1 t tq -- M_Po L U 13 -~ — — �Ipo t 161 a UAPO ?APO l- ().-q I Fecal Coliforms NIA11. ORIGINAL AND ONE C01'Y ON 'l RIS ANNUAL SUMMARY (INCLUDING ALI. "NO FLOW", "NO 1)INC:I IA3tGE" & LIMIT' VIOLATIONS) BY AIARCII I OF EACH )TAR'1'O: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 v)I9) 807-6379 YOU MUST SIGN THIS CF.R77FICATION FOR ANY INFORMATION RFPURTCD: "I eerlify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in aveortlaacc nith a ayslou designetl i„ assure that qualified personnel properly gather and evaluate the informatiun submitted. Based un my inquiry of the person. or persuns who inauage the yysteii,, m chose persons directly responsible for gathering the information, the infurmatiun submitted is, to the best of my km)N ledge and brlicf, tr-ur, uccurutc, and Votli ,lt-ty i atn aware that than a %t niftwill ue t rs for submitting false information, including the possibility loff fines and imprisoninent for knowing riolaliuus." -f (Sig lure of Permittee) (Date) Pormit Date: 11112010-121310014 l..a�,,[ Keyiscd 0)-0-' i I wc- i nt Part A Continued; Wastewater Monitarina Requirements MrTIA r901q 0ut[hll1�ahMN. r ` zhkj1r , r X Settleable Solids pH *tA2 Standard' 03101 it _. Meat o 3Ia I — C)31fb 0 31 n- r M?ol —M Po 1 +MP4l 03 04 A 0— — — - — - .—Apo P4 t Os/fLiflis — - - �l pot Q31151 K - M001 b 17 Fecal lbliforms rolhnl2t NIAIL ORIGINAL ANTI ONE COPY OF THIS ANNUAL SUMMARY (INCLUDINGALL "NO FLOW", "NO Illtii_'llrtltt:I'.:" .\ LIMIT VIOI.ATIONS) BYhf-iRCll I OF EACH YEAR TO: Division of Water Quality Attii: DWQ Central Files 1617 ?vlaiI Service Center Raleigh, North Catalina 27699-1617 �91Q) 907-6379 YOU AIUST SIGN THIS CERTIFICATION FOR ANY INFORMATION RRPORI ED. "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accuralstuce rri111 it S)'ACHI dr,iknral It, assure thal qualified personnel properly gather and evaluate the infurmaliun submitted. Based on my inquiry of the person or lice -suns who uranagv the system, r#1 11rose Persons directly responsible for gathering the information, the Information submitted is, to the best of my krrowtedgr and belicf, ii-ue, accurate, anti cunrl,WIV I am aware th§at thorn —e 0ornifioaut neu6il ks for submitting false infornialion, including the possibility of tines and imprisonment for knowing riuialions," _ 3l'1T1(g lti gnature ar Permitteel (pate) Permit Date: I/l/2010-12/31/2014 Lust Itevis(%t tie' -o-'- t i ! hvi i 1kt, ) Part A Continued: Wastewater Monitorine Reauirements A grd ;01 y 56#1eableSolids pH Fecal Cotiforms s�%r, x :; i4p N*•is; ,. t`* r [t11/12 Standard'coUml=.+ MPoI oqfs3! Soo �.�� - -- --- - _- - - — f`! Blot a - -- — Pot o5 ZQ07,4 _M Pa I og for. t q - — - ------ - - - Pa - - - MPoi 0 aSlf MPOI oY og /f4— c ---- MP6 M Pao d t�l - - - -------- -----— Pot isilq Soo 10. - G.act — thpol G.,`r (AFb� a4r7h9 300 - Satz MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY itNCLUDtNG ALL "NO FLOW",'*NO IDISCtIARGF" & LI1VUT VIOLATIONS) BY MARCH I OF EACH YEAR TO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919) 807-6379 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed it) assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who mttnagv the sY;teni, 01 (hose persons directly responsible for gathering the information, the information submitted is, to the best of my Liwwledge and belief, [rue, accurate, aatl romplc-u• I am aware. that tharr rare civnittaant peuall•Jes for submitting false information, including the possibility of fines and imprisonment for knowing violatioua." Iti✓r�nature o Perinitteet (Date) Permit Date: 1/1/2010-12/31/2014 last ifrvisrd 02-0 -{ Part A Continued; Wastewater Monitoring Requirements M" 10 iQ Ouito11 r o. .�^; +:: '� �' � ./, . Vie: � � ,r r� , f •.s r =� - �.�,;t ,.� SC_ttlasbte-.5ollds v..,e. pH Fecal (:oliforms Standard' collint'+,{ 601olliq I" o OF101/11 300 - b.S4 - - - - M USia4lt9 30a —6.151 axi —` - — 1`00 trot firs ILI 3pca Kpat MLIT 300 MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLONv-, -NO DISCI IA14C1,.7 &- LIMIT V101,ATIONS1 BY MARCII l OF EACH YEAR TO: Division of Water Quality chin: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919)807-6379 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "i certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a sPorttt designed lu assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persona who tnanage the system, o those persons directly responsible for gathering the information, the information submitted is, to the best of my knuwledge and belief', true, acvurate, and cumpicic I am aware.. that there sere cionifioant Reai—IDes for submitting raise information, including the possibility of fines and imprisonment for knowing ►•iulativus." 5/zl�l� i sign ure of �Prrrnjttee) (Date) Permh Date: 1/112010-12/31/2014 Last 1tr%c--.rd Kwr , n! Part A Continued: Wastewater Monitorine Requirements 5u✓tc. .20{q . Out}ltil i�lo ` 1 .., �t1T'rt,~} „yA �-, � ,tit�� �'1 .•wi¢ � • ( 9 h �w�i i ; _ EL,r v �etclaable:Sollds pH Fecal C'oliforms • i IA, Standard' L'Dt/itll�'� MPa( OWOV A . -- — — a IM Q ,-- Oo O,i L41- flat 06/06 t — -- -- �Prs C& /a4 9- UC. O — AkFbk Kpot a6113 HAIL ORIGINAL AND ONE COPY OF THIS ANNUAL.S.UNIMARY (INCLUDING ALL "NO FLOW", "NO DISCI 1ARGL" & L11�1 T VIOLATIONS) BY MARCH I OF EACH YEAR TO: Division of Water Quality Attu: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919) R07-6379 YOU AIUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance "All a system designed Iv assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or pri-som w lw nrauage the System, ul those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief', true, accurate, aml comilivir I am aware. that thPrP nrr cionifiwnt nev61@1es for -submitting false information, including the possibility of tines and imprisonment fur knowing viulmions." 05ign3fre Jr Perinitteel (Date) Permit hate. 1/1/2010-12/310-014 1.ust Rt:VjSrd ()_' lr' i 1 F'ari A Confirmed: Wastewater Monitoring Requirements J LL(, • 'IC C9 Outfall NO;- I r, e: s.�',•.:~- t, � � < # I ::, Solids PH Fecal Lotiforms `. ` tnlll' Standard2 �u[/in12.4 meol 07to1�� r!.Ikl /aYIC� — -- — - -- — -IMPo 67 a 4 NO k 11#A11, 0111GINAL AND ONE COPY OF THIS ANNUAL SUMMARY UNCLUDING ALL "NO FLOW", "NO 1)iSCHAKIL;U" 4` LIMIT yioi,.vrIONS) BY ALIRCH 1 OF EACH YEAR TO: i Fivklon of Water Quality Atin: I-)WQ Central Files I r, l 7 ;t l;t i t Service Center 1616ah, North Carolina 27699-1617 (,oI0 07-<;774 l'ob' J1l,:U SIGN THUS CERTIFICATION FOR ANY INFORMATION REPORTED. "I rerlify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accvrdanee with it systrul drsignrd Iq. assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who Fnamlgr the systenF, M Fh,Fec persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and be[iei-, trur, aCCUFHIe, 111ifl rLnnllb•u- I ant aware flint thorn swe cif=nifmant nevgll es for submitting false Information, including the possibility of fines and imprisonment fur knowing viulatiuFFs," IS' matnre of Permitteet (Date) 11i'mm fait,,- 111/2010-12/31/2014 Last Revisr-d 0-1-0' 1 1 F-';r..r , ,0 1 Parl A Continued: Wastewater Monitoring Requirements Q„4—�- aqq � " %i C1utl1tll l"�i►:; � 7i}i } _.1, > y, i� r : � g elil��r]lltl9 P H Feeal C:olif S :Mil? Standard' col/arI= 00 _MPOI fi{QGi o ee !D — i --- - — Af orms MAIL URICINAL AND ONE COPY OF THIS ANNUAL SUN MA1iY ItNCLUDlNG ALL "NO FLOW", "NO D!_SCHAI GL— &- LOUT \1101,,�TIONS) IIY AIARCH 1 OF EACH YEAR TO.: 1"ravishcn of Water Quality Alin: DWO Central Files rtil 7 11dail Service Celiter I:alria4r, Norlh Carolina 27699-1617 i 0lo Cli1-r;179 I o 111 ! LIN T.VIGN 77I1,5 Cli R7'11 "I Q 710A' FOR AN F INFORAL-1 T1 UN REPORTED: "I cerlify, ender penalty of law, that this document and all attachments were prepared under my direction or supervision in accordarncr with ar » seem designed ril !i"ier'e that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who inauagc thr sl•s1rin, of rhnsc her4nns directly responsible for gathering the information, the Information submitted is, to the best of my knowledge and belief, trur, accurate, anal cumiflrrx I am awar•r it abort art cioniYeotrnt nepfilt;es for submitting false information, including the possibility of fines and imprisonment for knowing viulatium," rat rr reel (Date) I>crmi! Ftarc: 1/1/2010-I2/31/2014 I_.ttsr Kevised lhAO. i "t"' tart A Continued: Wastewater Monitoring Requirements 51--p �_"b ._ 9-41Iy ".fir r �.• �r:�ii'. % s �tt�[s.�• :� l7ttII �'�?...S�eJ �+�I^t�+y]L ���� R+-� � y,�i�rA- {�y'ff'� rk r��r5. Y� 4� �'L�Ht..i.4g�{'AV Sift r- t51Vt I 4�V �.:I.�:A�I n''f[�R `�,'} t!� �' ��ajt �: �.ay�. � •'uf V.7+,: 1. 'a+.yR Ve 3� �;:1 �.e./., II j f� fj i 1.-kIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY (INCLUDING ALL "NO FLOW", -NO DISCHARGE" -K LIMIT %'101-ItTIONS) RY MARCH 1 OF EACH YEAR TO: I'Irvi.sion of Water Quality - - - AIIIII DWQ Central files t o 17 %'1:1i1 ",elvice Center I0Icigh, Milli Carolina 27699-1617 I'tl'>1 Q1�i-ri�79 VoU MI N►'S167N MIS CER'1'1FI[:. I T70A' FO►i .•IN}' IiVFORA1.91"IONREPUR7ED, "I evrtif., under penalty of lqw, that this document and all attachments were prepared under my direction or supervision in accurclancc %N itil to ,.stern dc:i+wticJ I,' :,.cnrt Mal 1lunlified Personnel properly gather and evaluate the infurmation submitted. Based on my inquiry of the person or persons �. ho utarl:rcc the .ystent, --I rlrrt:., 1wr•cnms directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belicl'.. Iran, uccuruty. tort! rontlolk-tt. I orn :In':rrr Ihnr ell rr +—e ioni nt "evilDes for submitting false infurmulion, including the possibility of rtncs and imprisunlneni fur klRM ing + iulntitrns." -� r (Slanature of Perml (Date) Ponnii Data: 1/1/2010-12/31/2014 I.Lasl Kvvisvd0"-tl'-I o PI,e , ill") 11:irl A Corrlinited: Wastewater Monitoring Requirements �(_}ta��r' )-Oi5 outfsn P40t __ � s a f�r •l a^ , ;. t:r i Y:� lj� ~ �� P _ f, _ i3� }Z� , II 1 NJ— --ti ii a1•µ{ I Li, 11 f` 6 laahlkSnllils pH Feral Cc d;•:. !'ri', r�,. x • ar 1=�. �, .. -mill, Standards c11141 m pO 1�- MQo b - IO +_9 .._ — ...NTO liforms NIr111. ORIGINAL AND ONE (DOPY OFTHIS HIS ANNUAL SUMMARY INC'.LUDI<NC ALL "_NO FLONN"', "NU_I)_ISCIIARC 1.4-- c\ Ll_MIT V101.ATION5) RV AIARCII I OF EACH YEAR TO: 1)ivisinn of Water Quality :�IIn DWO Cenlral Files I r, I) klaiI Service Cenier k,llrlRh. North Carolina 27699-1617 I `i I !11 RW7-0179 11)11 ilIIISTSIGN THIS CF_NTIF7CATION FOR ANY INFORA1ATION REPORTED: "I cer•tlf}I, under penalty of law, that this document and all attachments were prepared under my direction or supervision ill accurdance with ii systrnt dirsigned i,r :I"nry Thal qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person o1• persons who Manage tine system, ilr ihosc persons directly responsible for gailiering the information, the Information submitted is, to the best of my knowledge aitd helief, t►•ur, ticcurite, will comph•it- 1 :1111 aware t1t5bt if nirtoant Im sifts for submitting false information, including the possibility of tines and iniprisounient fur kitowiug viulalimis." +aar1 'e (It PC lice) (Date) llomw 1 im,%- 1/10010-12/.31/2014 L.,is1 Revisc-d ; of, , Part A Continued: Wastewater Monitoring Requirements cut? bci- col _ OutNll No: 1• � I]ateSample;V, �; yli" '«_ ?Totnr'Fiow ;, _— 'i'.° ri W' - •'S,� TotaUsu'spended4.. ,� ; , . SolidS .>:�- — is'"••. ; '-:"furbidlt}�;r, ; ' `f. Settle�bie So11ds ,� . L s'l'r: :pH•' ; _ ° Lqi� Fecal,Callfohns.. _ h ,_i• � mm/ddlyr;:. f; ��;'MG'. _ m-�,J� ;1�lTU' nil/l;-} r;.`i 'StaRiiard"r :couill• o, o I -- P- 00 01 11ob 14 0-- — �Dl— bl _- o� D I, r a r 9 It I r 4 -- — ftl 01 11 /i4hq 01 0 [ — O r 9— �I'Jo l rl Ir 3lrq — — MALT. ORIGiNAI AND ONE COPY OF TI11S ANNUAL, SUMMARY (INCLUDING ALL "NO ),:LOW", "NO DISCHARGE" & LIMIT VIOLATIONS) BY MARCH I OF EACH YEAR TO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919)807-6379 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons direct responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am awar the a sig ficant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." fir f Perm a (date) Pcrmit Date: 1/1/2010.12/31/2014 Last Revised Ot-21-11 Page 2 of 2 Part A Coufinued: Wastewater Monilorina Renuiremenls r r `ao rf • � - �3utfail'Nu Date Sarriple; '� � - ' t �`� nw _,, a =��`. T U �' � `� ` � .� otnl�S spcndcd ti' , r ' • :�Solids� "�-. � ., r ''1 Turbldily� f � a k- awel ��? - r Settlea6leSalyds r f , ; . G�f � ; } p=.-'pH -• ter: -�f, • Iecal Coiiformsw' t .: - - - Frl tgdd/yr _ j )'.'MG' =;.W y min +,--i t _ 'f iV711 ' ,? ; " , t , s' 4.`Staodiird-,` col/ri�l'. p I 1 i ¢ --r r— — -- M t7Im 9 MPOI /4 M01 4 0- -� - - -- 9 -- V I ~ r 1 /2 �+ a - -- a MAH, ORIGINAL. AND ONE COPY OF THIS ANNUAL, SUMMARY (INCLUDING ALL "NO FLOW", "NO DISCHARGE" & LIMIT VIOLATIONS) BY MARCH 1 OF EAr,,H YEAR TO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919)807-6379 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aW re that them are significant pc • o submitting raise information, including tlic possibility of t7nes and imprisonment for knowing violations." (Signature of rmil (Date) Permit Date: 111/2010-12/31/2014 Last Revised 01-21-1 I Page 2 of 2 L/ ;4 RESEARCh & ANA[yTICAI I � LAbORATQRIES, INC. AnalyticallProcess Consultations 05 April 2019 Mr. Kyle Hoover, P.E., P.G., PMP Environmental Protection Specialist III [RECF'1 F- Charah, LLC 435 South Tryon Street FEB 12 2019 Suite 180 Charlotte, NC 28202 {�{ +'►LEA SCripftl Dear Mr. Hoover: Enclosed is one (1) copy of the Brickhaven Mine Quarterly Wastewater monitoring analysis for the sample collected at the Brickhaven Mine site identified as MI'Ol on 28 March 2019. If you should require any additional information or have any further questions concerning the information contained in this report please feel free to contact me at 336.996.2841 or info@randatabs.com. Best Regards, Sidney L. Champion Executive Vice President Director of Laboratory Services Research & Analytical Laboratories, Inc. P.C. Box 472 • 106 Short Street • Kernersville. North Carolina 27284 • 336-996-2841 • Fax 336-996-0326 www.randalabs.com RESEARCH & ANA1YTiCAt Report of Analysis LA O RATO Ri ESF INC. 4/4/2019 ,i�,r- s ` ,rn,I, For: Charah, LLC .• ..••"••••••,/�(80 *�'� V C�o 435 South Tryon Street Suite 180 ��`�.���� ; Charlotte, NC 28202 CC z Q n i �n �tq NC#34 Z Attn: Kyle Hoover • s NC#37701 2 's ; Client Sample ID: MP01 Lab Sample ID: 64707-01 Site: Brickhaven Mine Collection Date: 3/28/2019 9:59 Parameter Method Result Units Rep Limit An� alyst Analysis Date[Tlme pH SM 4500 H+13-2000 5.40 Std. Units 3/28/2019 0959 Settleable Matter SM 2540 F-1997 <0.1 mIA 0A AW 3/29/2019 1430 Total Suspended Solids (TSS) SM 2540 0-1997 <5 mg/L 5 AW 4/2/2019 Turbidity EPA 180.1 6.33 NTU 1 AW 3/29/2019 1424 NA = not analyzed P.O. BOX 473 106 Short Street Kernersville, North Carolina 27284 Tel: 336-995-2841 Fax: 336-996-0326 WWW.Fandalabs.com Page 1 ral coo basir, vid REsFAR6 & AMALyTicAL UboRATOR!ESl Ific AnalytlCM / Process Consultations Phone (336)996-3B41 CHAIN OF CUSTODY RECORD IVater / filaste-wafer Afisc: �i,r•r•t �tidt•r„ !2`tl I'"�arcur�- Fla. ��-�.,w..r__—.�8rr'cjGl�3u,v,.. City. NF;ljv. Tip Itlin4 ar {.7rAN+�rASt�i... �5a7)G3i•oG-(3 Job INIP. •.. "Gl„ �� z C �_ > ' c F r- 8 r Y � d - o � Y C� a - T � u � - E v a v f�}'t•uject I t�(;.w Qu�.rTL (�claf�t,/a�Gr• d`1o�;-lar��y -Sampler lance (I'lease Prin(} San, {71cr Si}Inatur >� rad� •.amkirr Mute •fink.• CnmP. (;ra6 1 carp .t Rc3. C1. Chlorine Rctaor cd 1' ar tti SamPle Mutrix S ur \!' Sau,plc Locatian/ I.D. C T t Lab if�r Elnk)i It uestcJ 1 nalrsi� la�l�� 3r2 r4 x MPOI Seg. �« I�rh�,qui•chtd Iit' llnicfl'iker ~—rd�4 n� rd !i1 I};tFnfl'i ntc �� !Received By Hctuurks + (]n Ice Sample'lentperaturc at reccipt - L- •C r ' RESEARCh & ANA1yTICA[ �-� LABORATWES, INC. �r Analytical/Process Consultations CASE NARRATIVE One (1) water sample was received in good condition on 29 March 2019. The sample was analyzed without difficulties unless noted below (RAL #64707). J,,� // a-y,- GPI /01 Iy 1 Sidney L. Champion Director of Laboratory Services Date R 0. Box 473 • 106 Short Street • Kernersville, North Carolina 27284 • 336.996-2841 • Fax 336-996.0326 www.randalabs.com l.� RESEARC i & ANALyTICAI UbORATWES, INC. Analytical/Process Consultations 28 June 2019 Mr. Kyle Hoover, P.E., P.G., PMP Environmental Protection Specialist III Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Dear Mr. Hoover: Enclosed is one (1) copy of the Brickhaven Mine Quarterly Wastewater monitoring analysis for the sample collected at the Brickhaven Mine site identified as MPO1 on 24 June 2019. If you should require any additional information or have any further questions concerning the information contained in this report please feel free to contact me at 336.996.2841 or info@randalabs.com. Best Regards, Sidney L. Champion Executive Vice President Director of Laboratory Services Research & Analytical Laboratories, Inc. P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27284 • 336-996-2841 • Fax 336-996-0326 vAvwxandalahs.com RESEARch & ANA1YTiCA1 LAORATORiES, INC. For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 6/28/2019 ,���G�Pi✓ry�+�l.Y �i�I .�•� M NCtl34 NC 1137701 40 r Client Sample ID: MP01 Lab Sample ID: 68571-01 Site: Brickhaven Mine Collection Date: 6/24/2019 14:31 Parameter Method Result Units Rep Limit Analyst Analysis DateEime PH SM 4500 H+13-2000 6.24 Std. Units 6/24/2019 1431 Settleable Matter SM 2540 F-1997 <0.1 ml/I 0.1 AW 6/25/2019 1400 Total Suspended Solids (TSS) SM 2540 D-1997 <5 mg/L 5 AW 6/26/2019 Turbidity EPA 180.1 1.33 NTU 1 AW 6/26/2019 0923 NA = not analyzed P.O. Box 473 106 Short Street Kernersville. North Carolina 27284 Tel: 336-996-2841 Fax: 336-996-0326 www.randalabs.com Page 1 E iEI Cilia 1; Fi::. ' E'_i { RESEARCk & ANALYTICAL UbORATORIES, INC. Analytical / Process Consultations Phone (336) 4106-2941 CHAIN OF CUSTODY RECORD li'crtcr/ iVrrsleiJ�rrlcr Afixc•. !('mllps:nN�' j _ ('irr. 7,ih I lonoArcJ ('nlxr+ !'6rxrrc^T- �t ��i�.v►nbt1�3C.�'.. ($ozjGil-GG73 .lol) No. _ e � r � r � E C r `'' E C r o , — ° , 0. a 'L v" eel ti pler Name (I'icuse Print) �rArlbuS��L tiara tixnaJr `.vmlrr DOIC Time lump. Grab "Cernp R- Z. Nea. C!. Chlorine Rviumed V ur M M12161 S ur \i' Sample Loculion 1 I.D. 2= Sl sh if.r JLi11'1 Rat ucmcd Annll'tiis ' Apo a urb• kF1e SG� !J vlinlj lli5llcd tS5 �ilstldlilrl ' - �f,bceSLLt i Is, lraurrinre Ile tip Rcnra rk� no ti Ice tinmplr'IemperuJurral rccripl •�,�} °( — RESEARCh & ANA yTiCA1 LABORATORIES, INC. Analytical/Process Consultations CASE NARRATIVE One (1) water sample was received in good condition on 25 June 2019. The sample was analyzed without difficulties unless noted below (RAL 468571). /,�� // g�"— 06j28)J9 Sidney L. Champion Director of Laboratory Services Date P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27284 • 336-996-2841 • Fax 336-996-0326 ww w,rendalabs.com RESEARCh & ANA1yTICA[ ,-' LkORATWES, INC. Analytical/Process Consultations 30 August 2019 Mr. Kyle Hoover, P.E., P.G., PMP Environmental Protection Specialist III Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Dear Mr. Hoover: Enclosed is one (1) copy of the Brickhaven Mine Quarterly Wastewater monitoring; analysis for the sample identified as M111-01 collected on 22 August 2019. If you should require any additional information or have any further questions concerning the inf-ormation contained in this report please feel free to contact me at 336.996.2841 or infoPrandalabs.com. Best Regards, Sidney L. Champion Executive Vice President Director of Laboratory Services Research & Analytical Laboratories, Inc. P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27284 • 336-996-2641 • Fax 336.926-0326 www.randalabs.com WIN RESEARCh & ANA YTiCAt +3..qM LA ORATORIES, INC. L�220-wj For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 8/29/2019 r�surulrr��i J� \\& �rT/ ��ii o a 'a NC #34 Z. w s NC937701 Client Sample ID: Brickhaven Mine MP01 Lab Sample ID: 71281-01 Site: Charah, Inc Collection Date: 8/27/2019 10:02 Parameter Method Result Units Rep Limit Analyst Analysis DatetTime pH SM 4500 H+B-2000 5.99 Std. Units 8/27/2019 1002 Settleable Matter SM 2540 F-1997 Total Suspended Solids (TSS) SM 2540 D-1997 Turbidity EPA 180.1 <0.1 MIA 0.1 AW 8/27/2019 1430 <5 mg/L 5 AW 8/28/2019 8.42 NTU 1 AW 8/28/2019 0932 NA = not analyzed P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: 336-996-2841 Fax: 336-996-0326 www,randalabs.com Page 1 ;:a� co,^ to is :1ci RESEARCh & ANA[yTICA[ LAbORATORIES, INC. Analytical / Process Consultations Phone (336) 996-2841 CHAIN OF CUSTODY RECORD MME RESEARCh & ANA[yTICA[ LAbORATWES, INC. Analytical/Process Consultations CASE NARRATIVE One (1) water sample was received in good condition on 27 August 2019. The sample was analyzed without difficulties unless noted below (RAL #71281). Sidney L. Champion Director of Laboratory Services o C 130 Date P.O. Box 473 • 106 short Street • Kernersville, North Carolina 27284 • 336-996-2B41 • Fax 336-996-0326 www.randalabs.com RESEARC I & ANA[yTICAI -L4t�l LAbORATWES, INC. r� _,. . Analytical/Process Consultations 27 November 2019 Mr. Kyle Hoover, P.E., P.G., PMP L-'nvironmentai Protection Specialist III Charah, L I-C 435 South Tryon Street Suite 180 Charlotte, NC 28202 Dear Mr. Hoover: Enclosed is one (1) copy of the Brickhaven Mine Quarterly Wastewater monitoring; analysis for the sample collected at the Brickhaven Mine site identified as MP01 on 20 November 2019. If you should require any additional information or have any further questions concerning; the information contained in this report please feel free to contact me at 336996.2841 or infoCa�randalabs. corn. Best Regards, Z4 // A, --- Sidney L. Champion Executive Vice President Director of Laboratory Services Research & Analytical Laboratories, Inc. P.O. Box 473 • 106 Short SLreeL • Kernersville, North Carolina 27284 • 336-996-2841 • Fax 336.996.0326 www.randalabs.com KESEARch & ArWyTiW For: Charah, LLC 435 South Tryon Street Suite 180 Charlotte, NC 28202 Attn: Kyle Hoover Report of Analysis 11 /2612019 Iall Is i�•i z 4 NC $134 Z' '• NC#37701 s Client Sample ID: MP01 Lab Sample ID: 75093-01 Site: Brickhaven Mine Collection Date: 11/20/2019 12:21 Parameter Method Result Units Rep Limit Analyst Analysis DatelTime phi SM 4500 H+B-2000 6,57 Std. Units 11/20/2019 1221 Settleable Matter SM 2540 F-1997 <0.1 mill 0.1 AW 110/2019 1345 Total Suspended Solids (TSS) SM 2540 D-1997 <5 mg/L 5 AW 11122/2019 Turbidity EPA 180.1 3.67 NTU 1 AW 11122/2019 0922 NA = not analyzed P.O. Box 473 106 Short Street Ketnersville, North Carolina 27284 Tel: 336-996-2841 Fax; 335-996-0326 www.randalabs.com Page 1 ray! coa bar:-i;; v I RESmch & ANAlyTICAI UbORAmks, lNC. Analytical / Process Consultations Phone (336)996-Z841 CHAIN OF CUSTODY RECORD Winer / Wastewater Misc. Company t'+iO r1s 1uh No. 4 s M = � 6 g ° 8 � i V 'i � a d -1— H �' It cr, o i7 0 o 'a C s � aV 'a o � oV Street Address la`1l e+ie�tfe- Ia Project it�Gl�ta,�ev� M��e Quaff{erl City, State, Zip Maticure I.1C. 76�5^Q Sampler Name (Please Print) o C-91h IWAScV, Contact rai"e QtAwlLttSG� Sample Number Dale (Inb Urn Only) Phone �-431-04�3 Time Camp. Grab Samp er Signature Temp RM Chlorin! $amyle a Removed Matrix Sample t.ocaliaa ! I U. C CL Y ar N S w W 'aa o o Z k ursted Anal sib 3 t 20-tq r>'_ itrlinyulshrd By lint tl-Z Rmrti R ved' y Remarks B � W rlt i By Ualemme Received By Oo !re Sample Temperature at receipt�� -c